Ferncross Residential Home

Ferncross Residential Home is a care home providing personal care and accommodation to older people. At the time of the inspection, 12 people were receiving regulated activity at the home. The service can support up to 14 people. The home is an adapted building with bedrooms based over 2 floors.

People's experience of using this service and what we found

Aspects of staff recruitment were not effective at ensuring staff members were always suitable to work with vulnerable people. Some essential safety checks had not been made. There was inappropriate oversight of these processes by the provider. Further detail is in the 'safe' and 'well-led' sections of this report.

Medicines management was unsafe. The registered manager was unaware of the full details of which staff were administering medicines and some of the record keeping was poor.

Care planning and risk assessing needed input and review to ensure records were current and effective in providing essential guides to staff so that people were supported appropriately.

Although fire safety was a priority and the provider was working with the local fire service, other environmental safety issues needed addressing. These included concerns around gas safety, legionella checks and people's access to hot water.

Any checks the registered manager and management team were making, were not picking up on issues and had not identified the concerns seen at this inspection.

The registered manager was responsive to concerns we noted during the inspection and took action to make improvements and promote safety. This included taking action related to staff and arranging for a medicines audit to be conducted by external specialists.

People, their relatives and staff were confident in the management team at the home and praised how approachable they were. Staff said they were appropriately trained and supported. Records we saw supported this position.

Infection, prevention and control processes were appropriate, and we were assured about the provider's ability to reduce the transmission of infections.

Staff were competent about safeguarding processes and knew how to protect people from abuse. Relatives said their family members felt safe in the home and were trusting of staff and management.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to have access to healthcare professionals and specialist support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 23 May 2022).

At our last inspection we recommended that the registered manager acquainted themselves with legislative requirements as they related to health and social care. This had not been acted on and we established breaches of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and information received from partner organisations. As a result, we carried out a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 'Ferncross Residential Home' on our website at www.cqc.org.uk.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

Enforcement

We have identified breaches of regulations in relation to unsafe employment processes, medicines management, environmental issues, care planning and risk assessing and the governance/oversight of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority and other partner agencies to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect and will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Ferncross Residential Care Home is a care home providing accommodation and personal care to up to 14 people in one adapted building. The home provides support to older people and older people who are living with dementia. At the time of our inspection there were 14 people using the service.

People’s experience of using this service and what we found

People were protected from abuse and risks to their safety had been identified and managed. There were enough staff to support people. The registered manager carried out checks on new staff to ensure they were suitable to work in the home. People received the support they needed to take their medicines. We were not fully assured that all staff were consistently using Personal Protective Equipment, (PPE), effectively and safely. The registered manager took immediate action to ensure proper use of PPE. The registered manager learnt lessons from incidents and took action to improve the service.

Staff were trained and skilled to provide people’s care. Staff provided the support people needed to eat and drink and to maintain a balanced diet. The registered manager and staff worked with appropriate services to ensure people received the healthcare support they needed. The registered manager understood their responsibilities under The Mental Capacity Act 2005 and people’s rights were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated people in a kind and caring way by staff. Staff gave people choices about their care and support and respected the decisions people made. People's privacy, dignity and independence were promoted.

Staff provided people with person-centred care that met their needs and took account of their wishes. Visitors were made welcome in the home and people were supported to maintain relationships which were important to them. The provider had a procedure for receiving and managing complaints about the service. The registered manager had links with local and specialist services to ensure people received appropriate care as they reached the end of life.

The provider had developed a person-centred culture which focused on providing good care for people. They had identified areas of the service which required improvement and had developed a plan to address the issues identified. The registered manager and staff worked with other services to ensure people consistently received care that met their needs. The registered manager lacked knowledge about some areas of legislation and associated legal requirements. We have made a recommendation about improving their knowledge of legislation associated with providing the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection.

This service was registered with us on 25 February 2021 and this is the first inspection.

The service was previously carried on by a different provider. The last rating for the service under the previous provider was good, (published on 30 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Lancashire and South Cumbria. To understand the experience of social care providers and people who use social care services, we asked a range of questions in relation to accessing urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.